153
22 Phakic IOL implantation
Because of these distances between the pIOL and the endothelium, it would be currently safe. The
mimimum clearance between the pIOL and the endothelium was 1.22 mm calculated in 3D. The iris
convexity is shown on the lower right hand side of
Figure 178
.
However, what would happen as the patient grew older?
The crystalline lens grows approximately 19 μm per year. This would necessarily cause a shift of the
pIOL towards the endothelium, reducing the distance between them. A possible consequence would
be endothelial cell loss, a risk that must be taken into account and avoided. For this purpose the
Pentacam® offers unique aging prediction software which simulates the position of the pIOL after
10, 15 or 20 years.
Figure 179
shows the predicted distances ten years after pIOL implantation.
The horizontal Scheimpflug image shows a minimum clearance between optic edge and endothelium
of
1080 µm
, but the distinct minimum clearance, derived from the internal 3D-model between the
pIOL optic edge and the endothelium is
1.00 mm
, which is already borderline.
Figure 179: 3D pIOL simulation 10 years after implantation
